Retinoblastoma (RB) treatments include enucleation, radiotherapy, cryotherapy, laser photocoagulation and chemotherapy. Certain features of RB may be safely monitored without further treatment. The purpose of this study is to evaluate rates and describe features of retinal neovascularization associated with successful intravenous chemotherapy and focal consolidation of tumors with laser or cryotherapy.

Methods

Retrospective review of digital fundus images and medical records of RB patients who presented to the University of Illinois at Chicago, Illinois Eye and Ear Infirmary Retina Clinic from November 1, 2004 to November 1, 2014. Only surviving eyes that received treatment for RB with a minimum length of follow up of one year were included.

Results

50 eyes of 34 patients received treatment over the study period. 18 patients had unilateral RB, and 16 had bilateral RB. The mean age at diagnosis was 16 months. Of the 50 eyes, 22 were enucleated upon diagnosis. Most (86%) of the enucleated eyes were classified as International Classification of Retinoblastoma (ICRB) Group E. Twenty-five eyes received intravenous chemotherapy consisting of six cycles of carboplatin, etoposide and vincristine as the primary treatment. Twenty-two (88%) eyes (with 2 in ICRB group A, 6 in Group B, 10 in Group C and 4 in Group D) showed no tumor progression over the study period. Neovascularization was identified in 3 eyes (14% of 22 eyes) in 3 patients. These eyes were monitored closely without further treatment. The three eyes showed no tumor growth over respective periods of 9.1 years, 3.2 years, and 1.2 years. All 3 were associated with calcified regression, and 2 with preretinal fibrosis and subretinal fluid (one with inferior detachment successfully treated with scleral buckle).

Conclusions

The rate of retinal neovascularization in eyes with successful intravenous chemotherapy was approximately 14%. Neovascularization associated with retinoblastoma may be safely monitored without the need for further treatment if there are no signs of tumor progression.